Do I need a breast lift and are my breasts tubular? (Photos)

I'm 38 and I've had 4 children but have not breastfed. I've never liked the shape or size of my breasts. I'm scheduled for a breast augmentation and tummy tuck. I am going with either 350cc or 375cc subpectoral placement silicone smooth round implants. I feel like I may need a breast lift but my PS said I could get away without it. After all the reading I've been doing here and all the photos I've seen I'm also wondering now if my breasts are tubular.

Doctor Answers 28

Advice on current breast conditions.

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Thank you for your question.

Although it is not 100% clear, your photo seems to display ptosis (sagging) which is evident by the downward pointing nipple, and deflated breast. Your nipple may be near or below the fold under your breasts (inframammary fold), and your breast tissue is hanging mildly below the breast fold.

We all have different opinions and methods to correct sagging, but it would be my recommendation to that for best aesthetic results, the sagging should be fixed with a mastopexy (breast lift).

If you receive breast implants without the correction, then you will not only have to go with a larger than usual implant, but it will also appear too low on your chest (bottoming out). The weight of the implant will worsen the amount of sagging. You may also have a double bubble deformity where the breast tissue overlying the implant droops below in front of the implant. It may also cause a snoopy deformity (named after the cartoon character snoopy) that happens when the implant is held sitting in a high position by tight pectoral muscles, while the natural breast tissue falls off the implant and hangs below at the bottom curvature of your breast.

As such, you need a breast lift for best aesthetic results.

If you are afraid of scars brought on by a breast lift, you can get an initial breast augmentation, and if you become unhappy with your results, then you can definitely opt for a breast lift in the future.

Secondly, you do not have tuberous breasts. Tuberous breast is a congenital abnormality that occurs during puberty breast development. It can be classified by a combination of reduced breast diameter, underdevelopment of the breasts, areolar overgrowth, protrusion of the nipple areola complex, breast sagging, and breast asymmetry.

Thirdly, I would like you to know that breast sagging/drooping is associated with greater age, history of significant weight loss (>50 pounds), higher bmi, large bra-cup size, pregnancy, and smoking.

Also, please note that breast sagging worsens with the number of pregnancies you have, and that neither greater weight gain during pregnancy nor breast-feeding is found to be associated with a higher risk of breast sagging.

Additionally, there are many health fitness magazines and fitness trainers that propagate the claim that participation in regular upper body exercise prevents or corrects sagging. However, there is still no evidence of a protective effect. However, it is recommended to wear sports bra during exercise because the constant pull of gravity and the excessive movement during running can stretch the breast tissue possibly leading to sagging.

Hope this helps

Toronto Plastic Surgeon
4.9 out of 5 stars 508 reviews

A breast lift will help correct sagging.

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From your photos, it does not appear that you have tuberous breasts. However, there does seem to be some sagging. While breast implants will increase the size of your breasts, they won't improve the placement or position of your breasts like a breast lift can. Another advantage to having a breast lift is your plastic surgeon can reduce the size or adjust the placement of your nipples and areolas during the procedure. If you aren’t happy with your current plastic surgeon’s recommendations, it’s okay to seek out other opinions. Be sure to consult with a board-certified plastic surgeon. 


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Thank you for reaching out and posting photos. From looking at your photos, it does seem you might benefit and get the best results from a lift and possibly a reduction of the areola. But this can be best determined with an in person consultations, visit a few experienced board certified surgeons for second opinions and make sure you are on the same page with your end result goals and expectations. Best of luck! Dr. Kim

Daniel B. Kim, MD
Orange County Plastic Surgeon
4.6 out of 5 stars 16 reviews

Breast lift

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Hi, thank you for consulting me.

The plastic surgeon will place the implants and then will decide if it is necessary to lift it. I think that there is a high probability of needing the breast lift in your case. 

They don't look tuberous breasts.

Have a great outcome...

Gianna Ramos, MD
Dominican Republic Plastic Surgeon

Your breasts are not tubular

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You have sagging in your breasts, but they are not tubular.  You need breast lift, and implants placed behind your breasts, in my opinion.   

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

Lift with implants

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I don't think your breasts are tubular, but they are a little on the low side, and it would be nice to shrink their size somewhat.  So, I would recommend a periareolar incision, with a dual plane type III lift.  This will give you a lot of lift without a lot of scar, and will also help shrink the size of the nipples at the same time.  Not doing some sort of lift will likely lead to a snoopy deformity.  

Cain R. Linville, MD
Houston Plastic Surgeon
5.0 out of 5 stars 38 reviews

Do need a breast lift

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Thank you for your question. Based on the picture you need breast lift with implants for optimal results. Does not look like you have tuberous breasts. Please consult with a board certified PS for evaluation.

Do I need a lift, are my breasts tubular?

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Thank you for the question and the pictures.    I think that you would definitely benefit from a breastlift done with your augmentation.     You do not appear to have tuberous breasts.   I would discuss your goals with your surgeon.  Good luck

Richard Rosenblum, MD
Virginia Beach Plastic Surgeon
4.9 out of 5 stars 64 reviews

Breast lift with implant

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Hello and thank you for your question.   You do not have tuberous breasts.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, the best shape and contour could be achieved with an implant and a breast lift.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 160 reviews

Contemplating breast surgery

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You do not appear to have tubular or tuberous breasts. You would likely benefit from a breast lifting procedure at the time of your breast augmentation. This would also reduce the size of your larger areolas which may enlarge even more so following augmentation. It is probably worthwhile to return and discuss breast lift options again with your surgeon.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.